1538425673 NPI number — ZHENGZHUAN SHI MEDICAL P.C.

Table of content: (NPI 1538425673)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538425673 NPI number — ZHENGZHUAN SHI MEDICAL P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ZHENGZHUAN SHI MEDICAL P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538425673
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/08/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
255 1ST ST
Provider Second Line Business Mailing Address:
9A
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11215-1972
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-432-7248
Provider Business Mailing Address Fax Number:
347-227-8454

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
818 59TH ST
Provider Second Line Business Practice Location Address:
FL1
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11220-3612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-676-9398
Provider Business Practice Location Address Fax Number:
718-676-9397
Provider Enumeration Date:
04/03/2012

Additional Information

Authorized Official

Authorized Official Last Name:
SHI
Authorized Official First Name:
ZHENGZHUAN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
718-676-9398

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  255139 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 03533382 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: A100081689 . This is a "MEDICARE PROVIDER TRANSACTION ACCESS NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com